One category of complications is associated with the blind passage of the tape through the retropubic space causing bladder or bowel perforation, or vascular injuries. The other category is related to voiding disorders such as dysuria, or de novo urgency The retrourethral transobturator AdVance sling is a safe treatment option for male nonintrinsic sphincter deficiency SUI, with the main postoperative complication being transient acute urinary retention. Severe intra- and postoperative complications are rare and sling explantation rate is very low
Mid-Urethral Sling Obturator. This is a newer procedure for urinary stress incontinence. This procedure is performed under general or regional anaesthesia. A small incision is made in the vagina and the permanent tape is introduced via the vagina to sit under the urethra. The trocars used to introduce the tape are removed through small. Retropubic midurethral slings are still commonly used, but transobturator slings were introduced in 2001 with the goal of avoiding some of the complications of retropubic insertion (eg, bladder perforation, vascular injury, bowel injury) [ 5 ] All medical procedures come at a risk, though the transobturator sling procedure generally causes fewer mesh complications than the retropubic approach. Such complications may include neurological problems including weakness or numbness in the legs . Included were fourteen studies with greater than 100 patients that examined the retropubic midurethral sling using either TVT or SPARC and fourteen studies examining the transobturator approach. The TO slings included Uratape1 (Mentor-Porges, Le Plessis-Robinson
Dr. Greg Vigna discusses the unique risks associated with the arms of polypropylene retropubic and transobturator slings. Read on for information regarding sling related complications. There are a few risks involved in midurethral sling procedures, as with all surgical procedures: Injury to the bladder, bowel, blood vessels, or nerves Bleeding Infection of the urinary tract Difficulty urinating or other urinary problem The median estimated blood loss and operative time during the sling portion of the procedure were modestly, but significantly, higher in the retropubic-sling group than in the transobturator-sling. If you or a loved one suffered complications from Coloplast Aris-Transobturator Sling System, you may be entitled to recover compensation from a Coloplast Aris sling lawsuit or settlement Like all surgical procedures, there can be complications after bladder slings have been placed over the urethra. The most serious complications are often found years later due to pain the patients experience
Baron, Rigaud, et al. Management of post-operative urinary incontinence after mid-urethral sling explantation for pelvic or perineal pain. March 3, 2020. Misrai, Roupret, et al. Surgical Resection for Suburethral Sling Complications After Treatment for Stress Urinary Incontinence. The J of Urology. Volume 181, 2198-2203, May 2009 Sling procedures to treat stress incontinence. A sling is a piece of human or animal tissue or a synthetic tape that a surgeon places to support the bladder neck and urethra. Two sling techniques are shown — the retropubic and transobturator. Both are designed to reduce or eliminate stress incontinence in women Clinical Results and Complications The transobturator sling procedure was originally described in the Netherlands in 1998 and since then there have been thousands of TOT procedures completed in Europe. In France in 2001, Delorme introduced the transobturator sling procedure in humans Postoperative urinary tract infection (UTI) is a frequent complication with sling surgery with incidence varying from 8.9 to 34 %. The risk is similar with both retropubic and transobturator approaches .A 3-day course of antibiotics has shown to reduce the risk of postoperative UTI following sling surgery 
Complications associated with transobturator sling procedures: analysis of 233 consecutive cases with a 27 months follow-up Isabelle Kaelin-Gambirasio , 1 Sandrine Jacob , 1 Michel Boulvain , 2 Jean-Bernard Dubuisson , 1 and Patrick Dällenbach Abstract. Transobturator (TOT) placement of midurethral slings has demonstrated excellent efficacy similar to retropubic approaches with regard to treatment of female SUI; however, the TOT vector of implantation has also manifested a select and unique complication profiles This study aims to determine the complications associated with trans-obturator slings as reported to a national database. We required MAUDE, a database that collects reports of complications associated with medical devices and which is maintained by the Food and Drug Administration. We searched for complications associated with three different, commercially available trans-obturator. Transobturator (TOT) placement of midurethral slings has demonstrated excellent efficacy similar to retropubic approaches with regard to treatment of female SUI; however, the TOT vector of implantation has also manifested a select and unique complication profiles. In addition to recognized complications of all midurethral slings, including mesh erosion, postoperative voiding dysfunction, and. There were 928 MEDLINE citations for sling and complications, 279 for sling and complications and bladder, and 68 for sling and complications and voiding dysfunction. The reported complication rates ranged from 4.3% to 75.1% for retropubic and 10.5% to 31.3% for transobturator mid urethral slings
OBJECTIVE: The aim of our study was to identify and compare risk factors for failure of retropubic and transobturator procedures. STUDY DESIGN: This was a retrospective cohort study. Women with predominant stress urinary incontinence who underwent a retropubic (n = 214) or transobturator tape procedure (n = 173) were included With the evolution of surgical methods, mid-urethral sling (MUS) is the current mainstay surgical treatment of SUI. There are 3 different types of MUS, retropubic (RP), transobturator (TO), and single incision (SI). The RP-MUS has incisions on the abdominal wall and the vagina, and the tape is passed through the retropubic space What are the possible complications of mid-urethral sling surgery for SUI? Possible complications include bleeding, injury to surrounding blood vessels or perforation (making a small hole in the bladder), urinary tract infections, difficulty passing urine, and pain. Pain is more common following a transobturator sling procedure and can. Complications associated with transobturator sling procedure IUGA Academy. Szabová O. 06/29/18; 213180; 207 Topic: Stress Incontinenc Transobturator Route In the transobturator approach, a small incision is made in the vagina at the same place as for the retropubic operation. The ends of the sling are passed through two small incisions made in the groin. Each end of the sling passes through the obturator foramen, which is a gap between the bones of the pelvis
While numerous studies report long‐term outcomes and complications for the retropubic MUS, these are largely absent for the transobturator MUS and are assessed in this study. Methods. This is an Institutional Review Board approved retrospective chart review of all women who underwent a transobturator MUS at a single institution from 2004 to 2010
Complications associated with transobturator sling procedures: Analysis of 233 consecutive cases with a 27 months follow-up September 2009 BMC Women's Health 9(1):2 Transobturator Sling. Each Kit includes one flat curve and one set of helical introducers, providing physicians the option to choose their preferred transobturator (TO) approach for each patient. postoperative risks and potential complications of transvaginal mesh sling surgery Retropubic midurethral slings and transobturator tape procedures are currently the most commonly performed surgical procedures for treatment of stress urinary incontinence (44 Intraoperative complications of midurethral sling placement include substantial bleeding and bladder or urethral injury (52,56,57)
Mid-urethral sling (MUS) operations are a recognised minimally invasive surgical treatment for SUI. MUS involves the passage of a small strip of tape through either the retropubic or obturator space, with entry or exit points at the lower abdomen or groin, respectively. This review does not include single-incision slings The mini-sling is a smaller tape and requires less tissue dissection, and it might exhibit a lower risk of complications because it avoids the transobturator approach. In a clinical prospective study evaluating the Ophira mini-sling, 9 Palma et al reported that 88% of the patients were dry, and complications were not observed 12 months after. The transobturator approach to treat female stress urinary incontinence by means of a midurethral sling (MUS) placement was first described by Delorme to potentially prevent complications associated with the retropubic MUS placement originally described by Ulmsten (Delorme, 2001; Ulmsten et al., 1996) Why do I need a transobturator tape (TOT)? You will have discussed the options to manage your stress incontinence with your doctor and decided to have a transobturator tape inserted. What are the risks or complications? Serious complications are rare with this type of surgery. However, no surgery is without risk and the potential complications are
In 2016, Alwaal and colleagues compared complications related to slings (n = 597) versus AUSs (n = 608) and found that slings were associated with a lower complication rate at 30 days (2.8% versus 5.1%, p = 0.046). 17 Given these results and observing the results of this meta-analysis regarding the improvement of incontinence we could assume. In 2001, the transobturator approach was developed. This approach reduces the angle of the sling by passing it through the obturator canals -- the large holes on either side of the pubic bone Dr. Greg Vigna follows-up on his January 23, 2019 Press Release: Transobturator transvaginal mesh slings: Scars Remain on the Pudendal Nerve. Most certainly 2021 will be much better for the.
The McNemar test is calculated only for patients who did show up on both postoperative visits. TVT, tension-free vaginal tape; TVT-O, tension-free vaginal tape obturator; UUI, urge urinary incontinence.Houwert. Outcome and complications of retropubic and transobturator midurethral slings translated into STIs. Am J Obstet Gynecol 2010 I represent dozens of women with neurological complications caused by mid-urethral slings including those with destructive injuries caused by the Boston Scientific Obtryx device
Transobturator Tape Sling (TOT) This tension-free procedure has less of a risk of bowel and/or bladder injury when compared to the TVT sling due to the fact that it is not necessary to blindly pass a large needle through the retropubic space when the tape is inserted The characteristics of complications in retropubic and transobturator routes were compared and analyzed. Two hundred eighty cases with midurethral sling complications were suitable for analysis. Objetives: Compare the efficacy and post-surgical complications of single-incision sling (SIS) and transobturator band (TO) for the treatment of stress urinary incontinence (SUI) over 7 years' follow up. Methods: This is a prospective observational study that included 289 women with SUI who went under surgical treatment, either TO (109) or SIS (180) Introduction Stress urinary incontinence surgeries (transobturator tape and tension-free vaginal tape) are safely performed with success rates over 90%. The transobturator tape procedure attracted more attention due to the lack of major complications, such as intraabdominal organ and vascular injuries, related to the tension-free vaginal tape procedure. Although there are no major or mortality.
Transobturator slings have been available in the United States since the early 2000s and have quickly gained popularity due the reduced risk of retropubic space complications including bladder and bowel injuries and pelvic hematomas.1Y3 Complications associated with transobturator tape include mesh erosions, urethral injury, neuralgia, bleeding. The transobturator tape (TOT) sling procedure is a surgical treatment for female urinary stress incontinence. The aim of the procedure is to provide support to the bladder by placing a synthetic mesh (which acts as a sling) under the mid-portion of the bladder neck
Transobturator approach for mid-urethral sling - Operative steps RB Nerli 1, Sushant Deole 2, Sanjay Vijay Pujar 2, Shridhar C Ghagane 3, Murigendra B Hiremath 4, Neeraj S Dixit 3 1 Department of Urology, JN Medical College, KLE Academy of Higher Education and Research, JNMC Campus; KLES Kidney Foundation, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belagavi, Karnataka. BACKGROUND: Midurethral slings are increasingly used for the treatment of stress incontinence, but there are limited data comparing types of slings and associated complications. METHODS: We performed a multicenter, randomized equivalence trial comparing outcomes with retropubic and transobturator midurethral slings in women with stress. Obtryx Sling Complications. After treatment with a transvaginal mesh sling, many patients experience a variety of complications. In a less than three year period, the United States Food and Drug Administration received nearly 3000 adverse event reports related to the Obtryx Mid-Urethral sling as well as other transvaginal bladder sling devices Click here for information regarding sling-related complications. Greg Vigna, MD, JD Vigna Law Group 1155 Coast Village Rd., Suite 3, Santa Barbara, CA 1-800-761-9206. Greg Vigna, MD, JD Vigna Law Group + +1 800-761-9206 email us her P59 FEMALE UROLOGY: WHICH SLING? Friday, 7 April, 14.00-15.30, Room 252 / Level 2 977 978 COMPARISON OF TRANSOBTURATOR AND TRANSABDOMINAL PROSPECTIVE MULTICENTRE TRIAL OF MONARC™ TAPES FOR SURGICAL TREATMENT OF FEMALE STRESS URINARY TRANSOBTURATOR SLING FOR STRESS INCONTINENCE: 24 MONTH INCONTINENCE FUNCTIONAL DATA Sender H., Green J. Deridder D.1, Jacquetin B.2, Fischer A.3, Debodinance P.4.
Conclusions: The retrourethral transobturator AdVance sling is a safe treatment option for male nonintrinsic sphincter deficiency SUI, with the main postoperative complication being transient acute urinary retention. Severe intra- and postoperative complications are rare and sling explantation rate is very low TOT Sling Mesh Complications. Vaginal mesh complications can occur after the Transobturator Tape (TOT) transvaginal mesh implants. Mesh surgeon experts Drs. Miklos & Moore have removed hundreds of these surgical mesh complications including more than 100 complete TOT sling removals through the groin Objective: To describe surgical complications in 597 women over a 24-month period after randomization to retropubic or transobturator midurethral slings. Study Design: During the Trial of Midurethral Slings study, the Data Safety Monitoring Board regularly reviewed summary reports of all adverse events using the Dindo Surgical Complication Scale Dr. Vigna concludes, TOTs and defense experts are now on the clock. I represent dozens of women with neurological complications caused by mid-urethral slings including those with destructive injuries caused by the Boston Scientific Obtryx device. TOT related pudendal and obturator neuralgia is not rare and our first trial is going in May
Mini-slings can cause complications Mini-slings can cause complications Coskun, Burhan; Lavelle, Rebecca; Alhalabi, Feras; Lemack, Gary; Zimmern, Philippe 2014-10-23 00:00:00 Int Urogynecol J (2015) 26:557-562 DOI 10.1007/s00192-014-2530-7 ORIGINAL ARTICLE Burhan Coskun & Rebecca S. Lavelle & Feras Alhalabi & Gary E. Lemack & Philippe E. Zimmern Received: 10 June 2014 /Accepted: 29 September. Bladder Sling Complications. A bladder sling is utilized to deal with stress urinary incontinence (SUI) in women. A bladder sling is made from strips of medical mesh and is normally inserted through one vaginal incision and 2 little abdominal lacerations. SUI, which primarily happens in women, is the spontaneous loss of urine caused by. MAUDE Adverse Event Report: COLOPLAST COLOPLAST ARIS TOT SLING TRANSOBTURATOR VAGINAL SLING. Coloplast aris sling inserted for urinary stress incontinence. Immediate urinary retention requiring er visit for catheterization. Onset of severe left sided thigh, groin and buttock pain on day 3. Numerous visits to physician for eval of pain arising from the implantation of Mentor's suburethral sling product, ObTape Transobturator Tape (ObTape), to treat Plaintiffs for stress urinary incontinence. In these actions, Plaintiffs assert claims for design and manufacturing defect, breach of implied warranty, and failure to warn.1 ObTape allegedly cause
The transobturator tape midurethral sling was developed to minimize the risk of such injury by passing the tape retroperitoneally, through the obturator foramen. However, in the early 2000's, physicians and researchers did not have a clear sense of how the risks and benefits differed by procedure. In the trial of midurethral slings (TOMUS. typical sling-associated complications persist, including vaginal erosion.8 Fur-thermore, the US Food and Drug Ad-ministration-maintained Manufacturer and User Facility Device Experience Da-tabase has provided a series of reported complications associated with TO sling approach, including vaginal erosion, neuropathy, hematoma, urethral injury
sling, the transobturator sling, and the mini sling (FIGURE 1, page 44). Retropubic sling While complications from a midure-thral sling are rare, mesh exposures oc-cur in approximately 2% of patients, and urinary retention requiring release of the sling occurs in about 1% of patients.3,6 It of Mid-urethral slings are a synthetic mesh material that acts as a hammock, or sling, to support the urethra and prevent leakage. The urethra is the tube through which urine passes out of the body. One of the mid-urethral sling procedures tested by this study is transobturator, meaning through the obturator area of the pelvis Transobturator Sling Compared With Single-incision Mini-sling for the Treatment of Stress Urinary Incontinence. complications, and reoperation rates were also recorded. The efficacy was analyzed using a noninferiority test with a margin of 15%. For the noninferiority test, a P value >.05 rejects the noninferiority hypothesis of the mini. Among them, the transobturator sling (TOT/TVT-O) is widely used because of its high cure rate and lower number of complications [11,12,13]. However, persistent groin and thigh pain after surgery is the main complication affecting patient satisfaction [ 14 ]
is when the transobturator sling will be banned by the FDA, because the neuromuscular complications caused by the transobturator slings appear to be ten-times that of the retropubic slings. Synthetic polypropylene slings used in the treatment of stress urinary incontinence (SUI) include the retropubic sling, transobturator sling, and mini-slings The surgical repairs for stress urinary incontinence include retropubic sling operation and transobturator sling procedure. In the retropubic sling a mesh is placed beneath the urethra (a tube. Introduction and hypothesisTo compare the late complication profiles between retropubic and transobturator slings used for stress urinary incontinence was the objective of the study.MethodsBetween the years 2003 and 2010, 338 complications of midurethral slings were surgically managed in a tertiary referral center. For the purpose of study, we excluded slings that had materials other than. This modal can be closed by pressing the Escape key or activating the close button. This video from the Cleveland Clinic clearly describes the anatomy of the obturator space and the technique of transobturator sling, using illustrations, cadaver dissections, and live surgical footage Transobturator midurethral slings have demonstrated comparable efficacy relative to the retropubic approach with the potential to minimize the morbidity associated with retropubic needle passage. We present a case of recalcitrant medial thigh pain after transobturator midurethral sling placement that ultimately required medial thigh.
slings. AUS complications tend to be more severe. Our study sup-ports the use of slings as first-line treatment for mild-moderate PPI. Introduction Post-prostatectomy incontinence (PPI) is a devastating sur-gical complication, affecting about 1% to 57% of prostate surgeries.1 The disparity in PPI rates between studies reflect The study, available online in the New England Journal of Medicine, shows that both surgical procedures - transvaginal sling (TVT) and transobturator midurethral sling (TOT) - appear to be. The transobturator sling runs horizontally while the retropubic tension-free sling forms a tighter U. Clinical experience yields positive results Early European series and our initial experience suggest that the short-term efficacy of the Monarc transobturator sling is similar to that of the SPARC and TVT slings Artisanal Transobturator Sling Removal for Intractable Groin Pain. INTRODUCTION: The transobturator approach was first described by Delorme in 2001. It has become the preferred approach for suburethral sling placement in many centers due to its efficacy and low morbidity. Nevertheless, complications have been associated with it The Male Transobturator Sling System procedure is minimally invasive and consists of using two single-use needle passers and passing them through two small incisions over the obturator foramen. The needles are pushed in an arc through the tissue and exited at a perineal incision